Individual
MRS. CARLY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
333 IRVING AVE, BRIDGETON, NJ 08302-2123
(856) 575-4596
Mailing address
333 IRVING AVE, BRIDGETON, NJ 08302-2123
(856) 575-5496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
44SL06104700
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
44SC05910500
NJ
Other
Enumeration date
02/29/2016
Last updated
04/12/2023
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